The Managed Care Senior Contract Analyst provides technical and analytical support in the evaluation, negotiation, and maintenance of managed care contracts between Cook County Health & Hospitals System (CCHHS) and state/government payer networks. Works with CCHHS Information Technology (IT) and using data warehouse to develop and design data sets and reports.
Analyzes and summarizes contract performance data demonstrating projected vs actual increase or decrease to revenues, level of denials, underpayments and overpayments.
Monitors and reports changes in reimbursement by contracted payers and understands the impact on Health System's revenues.
Compiles data from various sources; cleans and formats data into meaningful reports, and updates information as needed.
Oversees production, review, and evaluation of managed care payer profile by service/product line.
Identifies areas of potential revenue enhancement through modification of pricing strategy or business office billing and collection procedures.
Troubleshoots data and conducts analysis using critical thinking and advanced problem solving skills.
Performs other duties as assigned.
Bachelor's degree from an accredited college or university (must provide official transcripts at time of interview)
Three (3) years of healthcare finance/managed care reimbursement experience (is required)
One (1) year of experience operational reporting/contract analysis (is required)
Intermediate skill in the use of Microsoft Excel, i.e. generating spreadsheets (is required)
Bachelor's degree in Finance, Accounting or related field or higher from an accredited college or university
Experience in database and data analysis technology, i.e. Crystal Reports, SQL
Knowledge, Skills, Abilities and Other Characteristics
Knowledge of cash handling operations
Strong verbal and written skills necessary to communicate complex technical concepts in a clear, concise manner to a wide level of personnel
Strong customer service skills with a strong response time to phone calls, emails, and customer requests
Strong interpersonal and problem solving skills
Ability to perform timely, accurate, and reliable mathematical and financial costings and reconciliations
Ability to multi-task and meet deadlines in a fast-paced and stressful environment
Ability to adhere to departmental policies and standards, utilizing best practices
Ability to prioritize, plan, and organize projects and tasks
Attention to detail and accuracy
Ability to troubleshoot and resolve issues, including, but not limited to, point of sale, customer, and staff
Ability to resolve conflict and diffuse difficult situations
When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service
To take advantage of this preference a Veteran must:
Meetthe minimum qualifications for the position.
Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, Are you a Military Veteran?
Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing.Please note:If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date.Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11)or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status.Discharge papers not listing an Honorable Discharge Status are not acceptable.
A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.
If items are not attached, you will not be eligible for Veteran Preference
VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW.
MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.
Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U.S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview.
Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.
CCHHS is strictly prohibited from conditioning, basing or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.
COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER
Cook County Health & Hospitals System is a public worldwide leader in medical care, research and education. Mission-driven. Patient-focused. Team-based. At CCHHS, nearly 6,000 dedicated professionals — working in every medical and surgical specialty — collaborate to provide health and hope and healing to people from all walks of life.Respect — Whether on the front lines of patient care or support...ing the efforts of your colleagues and co-workers, the work you do at Cook County Health and Hospitals System will help to save lives. You are a valued member of the team.Growth — At Cook County Health & Hospitals System you’re encouraged to build on your strengths and career goals.Diversity — County Health & Hospitals System actively seeks to bring together individuals with diverse thoughts, ideas and backgrounds and to promote an inclusive environment that will generate innovation, greater job satisfaction and, most importantly, continually improved patient care.